Thursday, March 31, 2005


I'm happy to report that my cycle is going very well. On retrieval day, there were 18 eggs. Of those, 13 have fertilized via ICSI, and are growing. So we have 13 little embryos across town!

My transfer is scheduled for Saturday at 7 a.m., at which time the doctor will talk with us about how many to transfer and how many to freeze, based on the quality of the embryos.<>

I'm starting to be excited now, amid all the fears and anxieties. It is a nice feeling. More later...

Monday, March 28, 2005

Baby makin' Wednesday

My RE's office called Saturday morning. Our donor was in on Friday and Saturday to have her follicles checked, and she now has 14 nice-sized follicles, which is lovely. Retrieval is scheduled for Wednesday, March 30th and transfer will be Saturday, April 2. We have to use ICSI because of my husband's poor sperm morphology, and I've written before about my epic bad luck...but I think with that many follicles, it is not unreasonable to expect we'll get to transfer with at least two embryos.

My husband takes it as fact that I'll turn up pregnant in a couple of weeks. Naive lamb that he is, he doesn't realize what a tragic miracle we are: Pregnant twice out of two IUIs and one IVF with my eggs, never more than 2 good follicles each time -- yet we lost both babies to miscarriage. He actually said to me, "Every other time you've tried, you've gotten pregnant." I boggled at him. "What?" he said, honestly puzzled.

Deft questioning revealed that he had, in fact, forgotten entirely about one of my IUIs -- the unsuccessful one. Previously, I've tried to be politically correct in my use of pronouns, but apparently, "our" isn't the right term to use since he can't even remember how many cycles we've done. Apparently this is my cycle and my DE baby.

This man-like lacuna in my husband's memory -- trivial in his eyes -- made me feel very alone in this process. And that is distinctly odd, considering that I'll have no part in the baby makin' this Wednesday. To be honest, I am more sad than I thought I would be as the time draws near. It is as if, in saying, "Hello, baby!" to this new life I'll perhaps be carrying Saturday, I am saying goodbye all over again to the children I lost to miscarriage, and to the ones I will never conceive on my own.

Perhaps this feeling has something to do with visiting the family. My brother and his wife, after their own struggle with infertility following the effortless conception of my nephew a month after their wedding, are pregnant with their second baby, a girl, from an IVF cycle. My sister-in-law is 39, the same age I was when I conceived and lost my babies. Shrink as I must to admit it, the truth is that although I am happy for them, and grateful they do not have to face the choices I've had to face, their success has ripped the wounds from my own failure.

I was doing pretty well at their house on Easter, where the family gathered for brunch after church. I chatted, helped make a fruit salad, tried not to notice how much fatter I am than my 15-weeks-pregnant sister-in-law. Yes, I was doing very well...until I saw, posted on a bulletin board in the corner of their kitchen, a collection of ultrasound photos of their healthy baby. You could see the little face, an arm raised as if to wave, that sweet round belly babies have.

My heart wailed in my breast. Last week, looking for a receipt so my husband could return something, I found in the side pocket of my purse my own ultrasound pictures from my last dead baby. My little Sam -- we learned he was a boy from a chromosome test after we lost him. So the images were fresh in my mind of my own little bean, my sweet boy who couldn't live because the egg I gave him wasn't strong enough to divide correctly. He had a uniformly lethal Trisomy 14. To add insult to injury, my sister-in-law's own sister was there too, prattling on and on about the pregnancy, and she happened to reveal some things I hadn't known: That the baby is a girl, and they're thinking of naming her Madeline.

That was to be my name for a girl baby. I hadn't quite talked my husband into it, but I'm sure I'd have gotten there in the end.

So, instead of being filled with a quiet, secret excitement at our own upcoming event, I found myself doing what I always seem to do at family parties...sneaking off to an upstairs bathroom to cry. It does no good to pretend that seeing those ultrasound photos, in such stark contrast to my own poor little one who was dead long before I could make out his face or his limbs, did not hurt me deeply.

I feel like scum today. Am I so selfish, that I can't allow joy to have the upper hand? Either for my brother and sister-in-law, who've had their own nightmarish struggle with infertility...or for myself, because I will soon have at least a chance to be pregnant again. I feel I should not begin my DE children's lives in grief for their dead siblings, and yet I can't seem to help it.

I wish I had never seen those ultrasound photos.

Oh well. I took my last Lupron shot this morning, and I will start progesterone-in-oil shots Wednesday night, leaving me exactly one puncture-free day. I wish I could push life's fast forward button to Saturday afternoon, when experience tells me I will be lying flat on my back, trying not to jostle my uterus no matter what the professionals say. From time to time I will pat my too-ample tummy and whisper, "How you doing in there, baby? Is it time to cue up the Mozart CD so you'll be a mathematical genius?"

It seems like I've waited forever for this, and yet it's all happening so fast.

Thursday, March 24, 2005

Counting my eggs before they're ICSI'd

In the spring, at Easter time, a middle-aged woman's fancy lightly turns to thoughts of...eggs.

What, you thought I was going to say love? In hopes that Lord Tennyson will pardon my paraphrase, I've got to go with Tina Turner on this one: What's love got to do with it? I won't even be in the building when my husband's bashful sperm are introduced (via ICSI) to my donor's pretty eggs, sometime next week.

Today I went to my RE's office for an ultrasound of my uterine lining and some bloodwork. They had to stick me twice to get my blood because I'm dehydrated, having been a victim of the flu recently. This was not so good, as I loathe needles. Later, the RE made up for it in giggles by making ballpoint-pen x's on my butt, in his earnest efforts to convey to my husband where he is to inject the progesterone-in-oil to get it into the muscle. I'm laughing all over again thinking about tonight: "Honey, I want you to look at my butt. No, really."

I took the opportunity to ask how our donor is doing. She was in this past Tuesday and has 11 follicles, all about the same size. This is a good thing, so that none are underdone or overcooked when she takes her trigger HCG shot. She will be checked again tomorrow. Then we'll know the exact dates of egg retrieval and transfer.

I must admit, although I would never wish either discomfort or the danger of overstimulation on our kind donor, that I had hoped for a few more follicles. My RE says that, as a grossly generalized rule of thumb, 50% are lost at every stage of the game. So, if we have 11, just 5-6 will be retrieved, and of those, 2.5-3 will fertilize and grow; if 2 are transferred to me, one may survive and grow into a baby. To the doctor, by those rules, 11 follicles is the perfect number, since a healthy singleton pregnancy is his ultimate goal.

But me, I'm both greedy and broke. I was hoping that we'd have enough embryos from this cycle to have two children, whether that's twins or by freezing embryos we don't use this time around. I plan to tell my child(ren) about their donor egg origins, and there's no way to know how they will feel about it. It could be important to them to have a full sibling. It will be years before we can afford to do this again, win or lose.

Oh well. Note to self: Self, stop the insanity. Don't worry about what you can't control, and by the way, how about a little gratitude for what you have? (Self's answer: "Shut. Up.")

My lining, by the way, was plush like a velvet Elvis picture: 12mm. The RE said they look for anything over 6mm. Padded walls for the embryos' playroom, I guess is the idea. The better for implantation, and making themselves to home.

Is it my fault I'm the type of woman who, when confronted with such good fortune, immediately wonders, "Is it too thick?"

Quite obviously, I'm the one who needs the padded walls. Infertility in general -- and donor egg in particular -- is crazy-making. It can create a schizofrenic where none was before. You think things like, "I'm so about a week I might be pregnant...Oh God I'm so scared, in a week I might be pregnant!" I long for the days when getting pregnant was a simple concept.

Doing donor egg is like standing in line all day at an amusement park, waiting to board the big rollercoaster. You shelled out big bucks just to get into the park. You're hot and impatient and bored while you wait. You mutter complaints to your husband about how long this is taking and wonder aloud whether it'll be worth it. You stand on your tiptoes to peer ahead at the front of the line, longing to be where those people are. You think you'll never get there, and then you do. At last.

But once you are actually on the ride, chugging up the hill toward that first big drop, your thoughts are more like this: "I'm so scared I'm so scared I'm so scared omigod why did I want to do this I'm so scared...!" Then you drop. You're falling. And you scream, in exhilaration and fear, all mixed up with total delight. That's what donor egg feels like to me.

So far, so good. Waiting to fall.

Thursday, March 10, 2005

Cold feet

This is really happening. I am really going to do this. Right?

I got a call from my clinic yesterday saying that our donor is downregulated and ready to start her stimulation drugs next week. I will start Estrace this Sunday, to build up my uterine lining for implantation. (Sadly, I have to keep taking the evil Lupron...I thought I'd get to quit when I began Estrace, as I did in my own IVF cycle, but this time around they don't want my ovaries getting in on the act at all.) Egg retrieval from the donor will probably be March 29, with transfer on April 1. I do hope that isn't an omen.

I carefully wrote all that down as the nurse was speaking, and after we hung up I meticulously transferred it to my calendar. And then I sat back and tried to figure out why the bottom had just dropped out of my stomach. Why all my doubts and fears about donor egg were beating about my head like a manic bird's wings. Why I suddenly had, as they say, cold feet. Isn't this what I've been waiting and working for? What I've been longing for? What I've been waiting for, working for, longing for, is a baby. A donor egg cycle as my method of family building was never high on my list of life goals, and it carries with it such a freight of stress and uncertainty that if it were a box on my doorstep, I'd call the bomb squad. Sometimes, donor egg feels too hot to handle.

Many have said to me, "Bee, you think too much." This is no doubt true, especially since the quality of my thought often leaves much to be desired (think pete-and-repeat jokes, weird David-Lynch-esque daydreams, and dustbunnies). But I think this decision I've made, this step I'm about to take, deserves some high-grade cogitation. This is huge. The hugest. I'm at the altar, about to say "I do." I am reformatting the hard drive that is my life, and I'm about to press ENTER. Or, try this metaphor: I'm about to jump off the high dive; I know there's water in the pool, but can I swim? Have I really got the stuff to be a good donor egg mother?

That's why I have the willies today. I am so very close to the point of no return. Assuming I am lucky enough to have embryos to put into my body on April Fool's Day, I will no longer be a woman dithering about donor egg and wondering if I can possibly slay all my dragons and be a good mother to my sweet maybechildren. On that day, with those embryos inside me, I will be a donor egg mother, if only for the time between transfer and beta HCG. I will be responsible for those potential children, and committed to raising them as best I can, with all the love and care I can muster. There will be no avoiding the pain I fear ahead, if they have problems or issues with their origins. On that day, there will be no going back. No "do overs," like we gave ourselves in childhood when we blew it playing kickball.

God, who wouldn't be scared?

It sure would be easier if my reproductive decisions were as simple as a smooth Merlot and a date with my husband. But they're not. I'd like to report that after a night of calm reflection, I arrived at a Zen-like serenity in my decision to be a donor egg mother. Or at least, a steely determination to stick to my guns, and damn the torpedoes.

But that would be bullshit.

The bald truth is, I was so freaked out last night, and so freaked that I was freaked after all the time and blog pixels I have spent on my DE decision, that I drank a big glass of wine -- I know, I know, bad me -- and tossed and turned all night. I look like hell today, and the only certainty I have is this: If I were to cancel this cycle, I would regret it forever.

See, I make all my life decisions based on one simple principle: How can I keep bad things from happening to me later? It's lowering, to realize what a true pessimist I am. If I chicken out, the "What if?" question will torment me like Marley's ghost. I will grieve my maybechildren if I don't at least try to become their mother for real.

So I am not going to shrink back from this, no matter how frightened I am. I'm off that high dive, and I don't care if I go splat. I'm going to take my vows. I'm going to press that button. I will take this leap of faith, and trust that wherever I land, I can make that place a loving home for me, my husband, and all our children.

Friday, March 04, 2005

Ladies in waiting

Not much to share today, except the bit of whimsy that follows. I've been a bit down. They say that women experiencing infertility have depression deeper than women undergoing cancer treatment. I believe it.

Earlier this week I called my egg donor coordinator for no real reason at all. I just wanted to hear her voice (isn't that sweet?). Our donor will be coming in sometime this week to see if she's down-regulated and ready to start stims, at which point the coordinator will call and strike my chains: No more Lupron! I can't wait for a mainline hit of Estrace, so I can stop sweating and start sleeping.

You know what gets me about this whole donor egg process?

Don't answer that. The replies would be legion. Today, however, my issue is with Waiting. And her hag of a sister, Worrying. I am a child of the first TV generation; I was born in 1964, the very last year of the Baby Boom. My attention span (unless I'm reading a really good book) has been irrevocably shaped by episodic drama and news-at-eleven sound bytes. Delayed gratification? Not.

So yeah, Waiting and Worrying drive me bughouse. They've been stopping by lately, hanging out, like good girlfriends do. Waiting asks me out to lunch a lot, trying to fill up my time. Worrying yap, yap, yaps in my ear and goes at me with her little rat teeth if I don't find some way to shut her up. I wonder sometimes, how many of our infertility decisions are driven by sheer exhaustion. We're tired of Waiting and Worrying. They're such bitches.

First I Waited to reach the top of my clinic's egg donation list. That took about a year, but I filled that time profitably by having my fibroid-infested uterus cleaned out, getting pregnant twice with my own eggs, and having miscarriages. Worrying had a field day during both of those pregnancies. After each ended, she smiled a smug and self-satisfied smile and said, "I told you so."

Reaching the pinnacle of the egg donation list was a less-than-welcome achievement after the worst year of my life, but it finally happened. Next, I Waited until a donor we liked became available. We passed on three donors for various reasons before we were matched. And then Waiting piped up: "Are you sure you didn't jump the gun a little bit? The next donor they offer might be just perfect. Maybe you should think about this. C'mon, let's you and me go out for a drink...."

I loved my donor's profile, and when I looked at her picture, I felt an instant click: Yes, that's the one. But our donor is not proven. I was just bored with Waiting. And Worrying reminded me that some other couple could snatch her up while I was dithering. (Our clinic gives you a week to consider a donor before they'll offer her to the next people on the list.) I caved.

Then, I Waited for our donor to recover from bronchitis, poor girl, and to get "Day 1" of her period. Never has the old auntie been so welcome, especially when not coming to my own house. Since then my donor and I have both been injecting ourselves with Lupron, in an attempt to downregulate and match up our cycles. This process is taking a very long time, but I have kept myself busy exchanging e-mail with Waiting and Worrying. (Is our donor taking care of herself? Is she taking her shots? Am I taking care of myself and taking my shots?)

In fact, I must thank Waiting and Worrying for this blog. It was their idea.

As soon as this cycle starts for real, Waiting and Worrying will be moving in to my house. I think they'll be sleeping in my bed and eating my food. They'll be very busy girls after my donor begins her stimulation drugs, and we face the whole how-many-eggs, how-many-embryos agony. And after transfer, they'll call their mother...the foul Queen of all the Waits, who reigns in the special circle of Hell named for Her: the Two Week Wait.

"Assuming you get that lucky," Worrying reminds me. "Not everyone gets pregnant from their first donor egg cycle." She's sitting on the edge of my desk, filing her nails to nice, sharp points. The better to scratch me with, later.

"Shut up," says Waiting, hovering behind me. She glances at her watch. "I told her to write a blog to kill a few minutes, and her lunch break is almost over."

Worrying pouts. "Well okay. No need to be rude. I was just saying."

I could get used to these two. I'd better.

Tuesday, March 01, 2005

Shania, I don't feel like a woman

I really don't. I heard that song of yours on my way home from work today. I'm not going out tonight -- who can afford it, when you're bleeding money from every orifice for infertility treatment? I'm not feelin' alright -- I could fry an egg on my chest from Lupron-induced hot flashes. But "Oh, oh, oh, go totally crazy" -- now you're playing my song, sister.

Of all the humiliations of being infertile, this one shrivels my soul: Infertility neuters me. From the moment I learned my ovaries could not produce viable eggs, I devolved from she to it. Or if you like, from young(ish) to old. Before, my wrinkles were laugh lines and my few gray hairs were extra blonde. After, my youth was over. And I had missed it.

Through sheer bad luck, I learned I was infertile on the day I found out I had uterine fibroids and a lump in my breast. I had scheduled my mammogram months before, and it happened to fall on the same day my brand new reproductive endocrinologist (RE) wanted to meet with us to assess the results of my Clomiphene Challenge Test (CCT) and perform a hysterosalpingogram (HSG). I almost rescheduled the mammogram, but the appointments are so hard to get, I let it stand. I was concerned that we hadn't become pregnant in six months of newlywed effort, but at 38, I was confident that one baby was achievable, even if we had to have medical help to do it.

We went first to the RE's office for the FSH blood draw and my very first ultrasound. I was shattered to learn that I had produced only one undersized follicle on the challenge dose of Clomid. Even uneducated as I was then, I knew that was bad. I started crying and barely held it together through the HSG, when the doctor told us that although my tubes were open, I had uterine fibroids that might interfere with a pregnancy. I remember my husband saying when I was still on the table, "She's already given up. Tell us, can she get pregnant?" The doctor looked at me with such pity in his eyes. "With her own eggs? Probably not. But let's see what her FSH is. I'll call you later today."

I was numb. We went to a restaurant and ate lunch; I managed only a few spoonfuls of soup. My husband offered to drive me to the mammogram, but I thought, "How much worse can this day get?" And he needed to pick up his son from Grandma's. So I drove myself. I got to the women's health center in the blackest of moods and filled out the paperwork. The receptionist called me up and said, "Now, we have to verify: Could you be pregnant?"

My heart twisted. I muttered, "No." The receptionist must have thought something was odd about my tone and body language, because she pressed, "You understand that x-rays can harm a fetus? Are you sure you're not pregnant?" I started crying -- again -- and burst out, "No! I'm not pregnant. I saw my uterus this morning and it was empty. It will always be empty because I'm infertile!"

Oookay. Psycho lady. They treated me very gently after that. I had the mammogram, got dressed, and waited. And waited. I wasn't all that surprised when they took me back in for the day's second ultrasound, this time on my top half, and told me I had a lump. I called my husband, and he said, "Oh, honey. I'll come get you..." But I told him there was no sense leaving my car stranded. I drove myself home, and by the time I walked in the door, I felt as if I'd been beaten. I went straight to bed. My husband came in and lay down beside me. He told me that the RE had called and my FSH was 40. I would never have a child with my own eggs, and he couldn't treat me further because his office did not have a donor egg program. I cried so hard I could barely breathe, and I remember saying to my husband, "I'm not me anymore."

When I got up that morning, I was a woman. I believed that my ovaries could start a child, my uterus could cradle one, and my breasts could suckle. By the time I went to bed, my ovaries were shrunken pits; my uterus bred fibroids and not babies; and my breast was possibly cancerous. In the span of one day, I had become an asexual thing. I felt deeply betrayed by my own body. By my self. (The breast lump, by the way, turned out to be benign.)

The next few months were grim. Besides delivering my doom, the CCT whacked my cycle and my hormones for two months afterward. Nights were a torture of hot flashes and sweats, and sex with my husband of six months? Puh-leeze. The whole idea, when I felt so unlovely, was faintly repulsive. I did it only when my calendar told me I must. I signed on with an equally pessimistic but more lenient RE who put me on Lupron to shrink my fibroids in preparation for myomectomy surgery. I had decided -- because I needed it to be so, and because the Internet is a Magic 8 ball; shake it enough and it will tell you anything -- that the doctors were wrong and that I could flog my ovaries into producing the fabled "one good egg."

We did two IUIs and one IVF, and miraculously, though I produced a pitiful one or two eggs each time on thousands of dollars worth of drugs, I became pregnant twice. But I lost both my babies, at 8 weeks and 9 weeks, after seeing slower than normal heartbeats. And if I thought I had reached the limits of self-hatred in my infertility, I had new depths to plumb after miscarriage. Real women, I told myself viciously, have healthy eggs to give their children. Real women can carry their babies to term. You are not a real woman.

And then I started to gain weight. You know what I'm talking about? Between the bloat-producing battery of drugs they gave me and the chocolate therapy I gave myself, the pounds started to creep on. Did I say creep? They practically leapt on me and wrestled me to the ground. Now, I look at my wedding pictures and then into the mirror, and I hardly recognize the person staring back at me with bleak eyes. Everywhere I turn, I'm confronted by gravid bellies for sale on eBay, or with lush, healthy young women who are so, well, young, that they've got to have eggs in there. I feel like an inferior life form.

Why should this be? I ask myself. If my liver were to die out from, say, an excess of tart New Zealand Chardonnay, or if I developed a stomach ulcer from hassling with my insurance company over IVF coverage, I would not allow those organ defects to affect my self-esteem. It would not even occur to me. So why is it different with my ovaries? Why, when we're not in the mood for His Softer Side and a man is behaving less than alpha, do we say, "Oh, just grow a pair!"

God, I wish I could. Gender is a part of us; it is our blood and bone, and because of this we are all, in some way, judged by our sexual characteristics. Although, I'm sorry, I can no longer scrape up any sympathy for small-breasted women. Between implants and Victoria's Secret push-ups, they're golden -- and God knows they'll have great racks when they get pregnant. Whereas, my ovaries are beyond rescue. My body simply cannot perform that most female of tasks: Conceiving and bearing a child.

Except...a small voice inside me whispers...except, that it can. If I allow myself to be still, and to peel away the layers of shame at my infertility, I come to this: Both men and women contribute sex cells to their children, but women do something extra. We nurture our babies within our own bodies. Even though my sex cells are damaged, I can still perform the one function that is unique to women.

And even if, in the end, I cannot do this, I will be a far better mother to any daughter that I adopt if I remember: There is more to a woman than her biology, and the greatest acts of motherhood are performed after a child is born.

So sing it, Shania. Maybe I'm a woman after all.